A contemporary understanding of iron metabolism in active premenopausal females

Abstract

Iron metabolism research in the past decade has identified menstrual blood loss as a key contributor to the prevalence of iron deficiency in premenopausal females. The reproductive hormones estrogen and progesterone influence iron regulation and contribute to variations in iron parameters throughout the menstrual cycle. Despite the high prevalence of iron deficiency in premenopausal females, scant research has investigated female-specific causes and treatments for iron deficiency. In this review, we provide a comprehensive discussion of factors that influence iron status in active premenopausal females, with a focus on the menstrual cycle. We also outline several practical guidelines for monitoring, diagnosing, and treating iron deficiency in premenopausal females. Finally, we highlight several areas for further research to enhance the understanding of iron metabolism in this at-risk population.

Longitudinal changes in anthropometric, physiological, and physical qualities of international women’s rugby league players

“…The observed changes in ferritin levels may be indicative of the increasing intensity of the training program and of the modest increases in lean mass observed during the pre-season period, a pattern consistent with the changes seen in female combat trainees over a 16 week basic combat training program [32]. Ferritin, unlike serum iron and transferrin saturation, tends to remain stable throughout the menstrual cycle [33], suggesting its specific role in capturing specific changes due to training load.…”

Longitudinal changes in anthropometric, physiological, and physical qualities of international women’s rugby league players

“…The observed changes in ferritin levels may be indicative of the increasing intensity of the training program and of the modest increases in lean mass observed during the pre-season period, a pattern consistent with the changes seen in female combat trainees over a 16 week basic combat training program [ 33 ]. Ferritin, unlike serum iron and transferrin saturation, tends to remain stable throughout the menstrual cycle [ 34 ], suggesting its specific role in capturing specific changes due to training load.…”

Does chronic oral contraceptive use detrimentally affect C‐reactive protein or iron status for endurance‐trained women?

“…Inference from research has suggested that prolonged use of OCP is a beneficial intervention for preventing iron depletion and the risk of iron deficiency as a result of the observed changes to menstrual bleeding (Alfaro‐Magallanes et al, 2022 ). Within athletic females, it is worth noting that iron status is consistently challenged through increases in iron loss through exercise‐associated mechanisms, inflammatory derived increases in hepcidin and subsequent alterations in iron regulation, increased risk of heavy menstrual bleeding, and low dietary iron intake from various dietary intake behaviors and patterns (e.g., vegan, vegetarian, macronutrient restrictive, and dietary restrictive; Badenhorst et al, 2022 ). The reduction in total iron lost through one of these mechanisms is likely to be considered beneficial for the sustainability of female athletic performance.…”